This unit applies to specialised exercise trainers, whose clients have been provided an exercise prescription from an accredited exercise physiologist or relevant medical or allied health professional.

The specialised exercise trainer applies the understanding and skills to deliver the program and modify the program in terms of frequency, mode, intensity and volume to accommodate the progression of the client within the parameters prescribed by the accredited exercise physiologist or a relevant medical or allied health professional.

They apply self directed application of knowledge and skills related to neurological impairment or disability, and exercise judgment in delivering the prescribed exercise. The specialised exercise trainer demonstrates the ability to analyse the clients responses to exercise and where appropriate consult with the accredited exercise physiologist or relevant medical or allied health professional.

Nil

ELEMENT

PERFORMANCE CRITERIA

1. Consult with clients presenting with neurological impairment.

1.1. Receive exercise referral from a relevant medical or allied health professional.

1.2. Confirm exercise referral has sufficient detail to allow flexibility for modifications to accommodate progression of the client.

1.3. Become familiar with typical adverse signs and symptoms that may arise during exercise for clients with neurological impairment or disability.

1.4. Consult with an appropriate medical or allied health professional as necessary.

1.5. Discuss with the client their complete exercise history and their neurological impairment and record relevant information according to relevant legislation and organisational policies and procedures.

1.6. Explain to the client the different roles of cardiovascular and muscular conditioning, and the reasons for their inclusion in the exercise prescription.

1.7. Confirm the outcomes of a goals and needs analysis in collaboration with the client and the medical or allied health professional if appropriate.

1.8. Explain to the client their need to be referred back to a medical or allied health professional if their condition becomes unstable.

1.9. Identify any potential barriers to exercise and discuss methods to enhance exercise adherence with the client.

1.10. Clarify any areas of concern with the referring accredited exercise physiologist or relevant medical or allied health professional, in conjunction with the client.

1.11. Obtain the informed consent of the client and maintain the client's records according to relevant legislation and organisational policies and procedures.

2. Consult with clients presenting with disabilities.

2.1. Receive exercise referral from medical and allied health professional if applicable or undertake pre-exercise screening with client.

2.2. Interpret referral and pre-exercise screening and seek clarification from medical or allied health professional.

2.3. Discuss with the client their complete exercise history and condition and record relevant information according to relevant legislation and organisational policies and procedures.

2.4. Explain to the client the role and benefits of physical activity in managing disabilities and enhancing health.

3. Deliver prescribed exercise programs.

3.1. Undertake appropriate fitness assessment as required.

3.2. Work with medical or allied health professional to deliver an exercise plan in accordance with recognised exercise recommendations, fitness test results, client limitations, and potential interactions of medications.

3.3. Explain to the client the different roles of cardiorespiratory and muscular conditioning, and the reasons for their inclusion as part of the client's exercise prescription.

3.4. Explain to the client the exercise variables to be implemented in the context of managing their specific cardiorespiratory conditions.

3.5. Apply instructional techniques to ensure safe and appropriate application of the exercise program by the client.

3.6. Demonstrate the safe and appropriate use of selected exercise equipment and report or address any unsafe equipment according to organisational policies and procedures.

4. Monitor and review clients responses to the prescribed exercise program.

4.1. Monitor perceived exercise intensity and make adjustment as required.

4.2. Assess the client's performance and explain and correct any unsafe exercise procedures.

4.3. Monitor client responses for any typical signs and symptoms requiring intervention that may occur during exercise.

4.4. Apply procedures to respond to signs and symptoms requiring intervention as required according to relevant legislation and organisational policies and procedures.

4.5. Recognise signs of an unstable condition and refer the client back to an appropriate medical or allied health professional.

4.6. Monitor progress and report outcomes to the client.

4.7. Revise the client's record and advise the referral source of suggested changes to the exercise program if required.

5. Provide advice regarding additional lifestyle modifications to enhance the management of the disability or neurological impairment.

5.1. Obtain information about the client's current lifestyle.

5.2. Discuss possible barriers to behaviour change and implementation of healthy eating practices.

5.3. Provide information about the fundamental features of balanced nutrition and recommend modifications to dietary intake to improve general health and reduce the risk of cardiovascular disease.

5.4. Recommend other lifestyles changes to improve current disease status.

Required skills

communication skills to:

elicit and convey information to clients with neurological conditions or disabilities

develop rapport with clients

clarify potential risks and concerns with treating medical or allied health professionals

Problem-solving skills to identify adverse signs and symptoms requiring intervention and unsafe exercise performance and to recommend appropriate changes in consultation with an appropriate medical or allied health professional

teamwork skills to work collaboratively with medical and allied health professionals according to all legal and ethical considerations

decision making skills to determine suitable exercise selection and progression

analytical skills to interpret information on the health and functional status of clients with disabilities or neurological impairments in terms of their medical conditions, risk factors, medical treatments and exercise history

literacy and numeracy skills to enable the accurate interpretation of referrals and to record client exercise programs and calculate and adjust exercise duration and frequency.

decision making skills to determine appropriate instructional techniques.

literacy skills to accurately document and report on client progress.

Required knowledge

physical and cognitive consequences of common neurological impairments likely to be encountered in the exercise setting including:

cerebral palsy

multiple sclerosis

Parkinson's disease

spinal cord injury

acquired brain injury

stroke

dementia

muscular dystrophy

autism spectrum disorder

effect of neurological conditions on the acute response to exercise to enable assessment of the individual's functional capacity when developing exercises

anatomy and physiology of the musculoskeletal system and its supporting systems to enable appropriate design of exercise programs

nervous system and its relationship to movement

digestive system and its relationship to exercise performance

physiology of specific disabilities and associated risk factors in relation to exercise to enable safe and effective exercise outcomes

causes and consequences of specific disabilities in the context of their effect on exercise capacity and the role of physical activity in managing disability and enhancing health

directional and movement terminology to enable effective communication with medical and allied health professionals

range of motion and stretching techniques to enable the inclusion of exercise variables to suit client's functional capacity

the role of physical activity in improving functionality in clients with neurological conditions

relevant legislation and organisational policies and procedures to maintain the safety of clients and the confidentiality of client information

use, care and maintenance of facility equipment to maintain safety of clients and other facility users.

The evidence guide provides advice on assessment and must be read in conjunction with the performance criteria, required skills and knowledge, range statement and the Assessment Guidelines for the Training Package.

Overview of assessment

Critical aspects for assessment and evidence required to demonstrate competency in this unit

Evidence of the following is essential:

communicates effectively with medical or allied health professionals regarding relevant health and functional status of the referred client

effective communication skills to discuss aspects of exercise prescription with clients

when appropriate, react to adverse events to deal with exercise program problems and issues

ability to correctly interpret the exercise prescription and make modifications consistent with prescribed parameters and scope of practice

safely and effectively delivers exercise for referred clients with disabilities and neurological impairment and recommends appropriate alterations according to client's physical and motivational responses

monitors and maintains the safety of clients, exercise equipment and the exercise setting and applies effective contingency management techniques to deal with problems and issues that may arise during the exercise program

applies all relevant legal and ethical requirements when discussing and recording client information

demonstrates appropriate manner, empathy and patience when working with clients with disabilities and neurological impairment

Context of and specific resources for assessment

Assessment must ensure demonstration of skills over a period of time within a facility where a variety of exercise modes and equipment are available to support effective exercise for clients with disabilities and neurological impairment.

Assessment must also ensure access to:

a facility where a variety of exercise modes and equipment are available, such as exercise machines, weight machines, exercise mats and adequate floor space

a range of clients with real or simulated neurological impairment from a range of ages

a range of clients with real or simulated disability from a range of ages

a range of real or simulated medical and allied health professional referrals for a range of clients with neurological impairment

demonstration of skills on sufficient occasions to determine competence in interpreting relevant information and delivering the prescribed exercise program for a range of clients with disabilities and neurological impairment.

relevant documentation such as client record forms.

Method of assessment

A range of assessment methods should be used to assess practical skills and knowledge. The following examples are appropriate for this unit:

observation of consulting with clients and adjusting standard exercise prescriptions to account for a range of neurological impairments, disabilities and risk factors to focus on functional capacity and health rather than physical fitness

observation of dealing effectively with a range of contingencies such as real or simulated client injuries or inability to complete the exercise prescription

oral and or written questioning to assess knowledge of physical and cognitive consequences of common neurological impairments and disabilities likely to be encountered in the exercise setting

third-party reports from a supervisor detailing work performance.

Holistic assessment with other units relevant to the industry sector, workplace and job role is recommended.

Guidance information for assessment

The range statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Bold italicised wording, if used in the performance criteria, is detailed below. Essential operating conditions that may be present with training and assessment (depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts) may also be included.

Medical or allied health professional may include:

sports physician

sports doctor

general practitioner

physiotherapist

accredited exercise physiologist

occupational therapist

remedial massage therapist

chiropractor

osteopath

accredited practising dietician

podiatrist

psychologist

aboriginal health worker.

Client may include:

older

sedentary

overweight or obese.

Neurological impairment may include:

cerebral palsy

acquired brain injury

stroke

Parkinson's disease

multiple sclerosis

spinal cord injury

dementia

autism spectrum disorder

muscular dystrophy

spasticity.

Disability may include:

intellectual

physical

neurological

sensory.

Relevant legislation may include:

Occupational Health and Safety

duty of care

privacy

codes of practice

fair trading.

Organisational policies and procedures may include:

Occupational Health and Safety

emergency procedures

risk management

use of client record systems

collection and use of client information

equipment use and maintenance

client supervision

incident reporting

client screening procedures

client referral procedures.

Muscular conditioning may include:

muscular strength

muscular power

muscular endurance

Goals and needs analysis may include:

timeframes

appropriate exercise program adjustments

barriers

motivation.

Barriers may include:

physical access

client attitude

perceived limitations.

Methods to enhance exercise adherence may include:

rewards for attendance and participation

statement of intent

perceived choice

goal setting.

Records may include:

electronic

hand written.

Pre-exercise screening may include:

medical clearance

current client condition

medical and exercise history

functional limitations

medication

fitness goals

time availability.

Disabilities may include:

paraplegic

quadriplegic

visually impaired

hearing impaired

cerebral palsy

chromosomalabnormalities:

down syndrome

turner syndrome

chronic pain

brain injury

amputee

intellectual disabilities

stroke

muscular dystrophy

joint replacement.

Fitness assessment may include:

neurological or relevant disability response to exercise

range of movement

strength

girth measurements

posture.

Instructional techniques may include:

demonstration

explanation

positive feedback

motivational strategies.

Exercise program may include:

exercise selection

exercise sequence

exercise variety.

Exercise equipment may include:

free weight equipment

resistance training machines

hydraulic machines

aquatic equipment

resistance bands.

Monitor client responses may include:

rating of perceived exertion (RPE)

heart rate measures

'talk test'

direct observation.

Symptoms requiring intervention may include:

shortness of breath at rest or with mild exertion

dizziness or syncope

unusual fatigue

illness or sickness

weakness

neck pain or strain

pain on movement of any body part.

Procedures to respond to signs and symptoms requiring intervention may include:

cessation of activity

first aid

emergency medical assistance

referral.

Signs of an unstable condition may include:

fatigue and weakness

cardiac pain

breathlessness

oedema

palpitations

claudication pain

dizziness.

Lifestyle modifications may include:

moderation of alcohol consumption

cessation of smoking

increased incidental activity

stress reduction

provision of health eating guidelines

provision of healthier choices.

Alterations to the exercise variables may include:

duration

frequency

intensity.

Pre-exercise screening may include:

initial screening may consist of:

questionnaire

interview

medicalclearance

initial screening should determine whether the client:

has a medical condition

has an injury

is on prescribed medication

forms used:

pre-activity screening questionnaire

informed consent

medical clearance

information obtained:

medical history

functional limitations

medication

lifestyle evaluation

fitness goals

exercise history

time availability.

Unit sector

Fitness

This unit contains employability skills.